Refining contextual inquiry to maximize generalizability and accelerate the implementation process

Abstract

Background: While contextual inquiry, or in-depth mixed-methods work to study the implementation context, is critical for understanding the setting in which a behavioral health evidence-based practice (EBP) will be implemented, current methods to determine potential barriers and facilitators to implementation are often conducted in a single setting and/or for a single EBP per study, often taking 1–2 years to complete. To maximize generalizability and reduce the research-to-practice gap efficiently, it is important to move toward cross-sector and/or cross-EBP contextual inquiry. Methods: In this viewpoint, we argue for (a) collaborative research studies that seek to identify determinants of implementation that are similar and unique across different settings and EBPs, using rapid approaches when possible; (b) enhanced synthesis of existing research on implementation determinants to minimize duplication of contextual inquiry efforts; and (c) clear rationale for why additional in-depth or rapid contextual inquiry is needed before it is conducted. Throughout this viewpoint, the need to balance scientific rigor and speed are considered. Conclusions: Overall, this viewpoint seeks to encourage researchers to consolidate and share knowledge on barriers and facilitators to implementation to prepare for the scaling out of much needed implementation strategies and interventions for improving health. Plain language summary: Significant time and resources are often devoted to understanding what makes it easier or harder to use best practices for behavioral health concerns in health care settings. The goal of the current viewpoint is to offer ways to streamline this process so that high-quality behavioral health services can reach the patients that need them more quickly. In particular, we advocate for ways to share knowledge among researchers and learn from prior findings to more efficiently identify what makes it easier or harder to use best practices for addressing behavioral health problems in a given setting (e.g., primary care, schools, specialty mental health).

The Lean Six Sigma Define, Measure, Analyze, Implement, Control (LSS DMAIC) Framework: An Innovative Strategy for Quality Improvement of Pharmacist Vaccine Recommendations in Community Pharmacy

“…Future directions for pharmacy stakeholders, including researchers, leaders, practitioners, and policy makers should include thorough contextual analysis of all possible barriers and facilitators for clinical pharmacy services, including vaccination programs, medication therapy management, point-of-care test-and-treat models, and others [ 17 ]. This contextual analysis, sometimes referred to as contextual inquiry, often uses a mixed-methods approach of quantitative and qualitative data analysis to understand all possible barriers and facilitators to achieving a given objective.…”

“…This contextual analysis, sometimes referred to as contextual inquiry, often uses a mixed-methods approach of quantitative and qualitative data analysis to understand all possible barriers and facilitators to achieving a given objective. On the pragmatic side of healthcare, this is often called CQI as in our study; however, on the research side of healthcare this is referred to as implementation science [ 17 , 18 ]. In either case, there is a plethora of tools, theories, frameworks, and methods available across both ends of this spectrum which may aid pharmacy stakeholders in improving the overall quality of the pharmacy experience [ 19 ].…”

Four strategic areas to advance equitable implementation of evidence-based practices in cancer care

“…Critiques of implementation science have argued that the field is recreating the research-to-practice gap in the field (i.e., implementation practice is not informed by research) and that it takes too long to get to the action (i.e., spending too much time on contextual inquiry) [ 79 ]. As such, there have been calls for more rapid learning (also called rapid implementation science) to align with the time frames called for by policy and health system decision makers both in the methods used to collect contextual data and for generating recommendations [ 80 , 81 ].…”

Comparing Output from Two Methods of Participatory Design for Developing Implementation Strategies: Traditional Contextual Inquiry vs. Rapid Crowd Sourcing

“…It is not clear which participatory design approach an implementation scientist should pick when engaging end users in implementation strategy development for a target EBP, nor is it known whether different approaches will lead to varying results. To our knowledge, no one has compared the results of using different approaches of participatory design on the resultant implementation strategy output (10) This study compared output from two participatory design approaches: (1) a traditional contextual inquiry approach (i.e., eld observations and qualitative interviews with stakeholders) versus (2) a more recent addition to the panoply of participatory design tools, an innovation tournament. Innovation tournaments are a more rapid approach to participatory design that involve a kind of crowd sourcing -a competition in which members of a group can submit ideas about how to address a challenge.…”